The nurse is planning health teaching about omeprazole for a client who has acute gastritis. What statement will the nurse include in the health teaching?

"You can crush this medication if you have trouble with pills.”

"Avoid alcohol while taking this drug"

"You will need to take this medication for the rest of your life.’

"Take this medicine first thing in the morning."

Answer and Explanation

The Correct Answer is D

Omeprazole is a proton pump inhibitor (PPI) that irreversibly binds to the hydrogen-potassium ATPase enzyme system. This pharmacological action effectively suppresses gastric acid secretion from parietal cells, facilitating mucosal healing in acute gastritis. It is most effective when the pumps are actively stimulated by meal ingestion, typically requiring administration 30 to 60 minutes prior to eating.

Rationale:

A. Omeprazole is formulated as a delayed-release capsule containing enteric-coated granules to protect the medication from degradation by stomach acid. Crushing the medication destroys this protective coating, leading to premature activation and significantly reduced therapeutic efficacy. Patients with dysphagia should seek alternative liquid formulations or specific administration protocols provided by the manufacturer.

B. While avoiding alcohol is general advice for gastritis to prevent direct mucosal irritation, it is not a specific pharmacological requirement for omeprazole itself. Alcohol does not have a direct, dangerous drug-to-drug interaction with PPIs, although it counteracts the healing process. The clinical focus of medication-specific teaching remains the timing of the dose for optimal efficacy.

C. Acute gastritis is typically a self-limiting or short-term condition once the offending agent is removed and the mucosa heals. Stating the patient will need the drug for the rest of their life is medically inaccurate and pertains more to chronic conditions like Barrett's esophagus. Prolonged PPI use is associated with risks like osteoporosis and Clostridium difficile infections.

D. The nurse should instruct the client to take the medicine first thing in the morning. PPIs work best when administered on an empty stomach before the first meal of the day to coincide with the maximal activation of proton pumps. This ensures that the drug is present in the bloodstream to inhibit acid production triggered by breakfast.

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Correct Answer is A

Explanation

Esophagogastroduodenoscopy(EGD) is the gold standard diagnostic tool for evaluating the upper gastrointestinal tract. This endoscopic procedure allows for direct visualization of the esophageal, gastric, and duodenal mucosa to identify ulcers, tumors, or inflammation. It is superior to imaging because it facilitates the collection of biopsy specimensto test for Helicobacter pylorior malignancy.

Rationale:

A.Esophagogastroduodenoscopy (EGD) is the expected procedure for investigating gastric pain and dyspepsia. It allows the clinician to directly visualize the interior of the stomach and duodenum to identify the cause of the pain, such as peptic ulcer disease or gastritis. During the EGD, the provider can also perform therapeutic interventions or take biopsies, which is essential for a definitive diagnosis.

B.Magnetic resonance imaging (MRI) provides detailed cross-sectional images of internal organs but is not the first-line choice for mucosal evaluation. While MRI is useful for identifying solid organ tumors or complex anatomical issues, it cannot visualize the surface of the gastric lining with the clarity of an endoscope. It also lacks the ability to take tissue samples, making it less diagnostic for dyspepsia.

C.A nuclear medicine scan, such as a gastric emptying study, is used to assess the motility of the stomach rather than its structural integrity. This test is helpful for diagnosing gastroparesis but is not the standard initial test for undiagnosed gastric pain. It involves the ingestion of radioactive isotopes, which is unnecessary when direct visualization via endoscopy is indicated first.

D.An abdominal arteriogram is an invasive procedure used to visualize the blood vessels of the abdomen, typically to identify blockages or hemorrhages. It is not used to evaluate dyspepsia or routine gastric pain unless a severe vascular issue like mesenteric ischemia is suspected. For mucosal inflammation and common epigastric pain, the EGD remains the most appropriate and direct diagnostic tool.

A. Being exposed to blood or blood products B. Having unprotected sex C. Sharing needles for illicit drugs D. Eating contaminated food or water

Correct Answer is D

Explanation

Hepatitis Ais an acute, self-limiting viral infection of the liver caused by the HAV virus. It is primarily transmitted through the fecal-oral route, often involving the ingestion of substances contaminated by an infected person. Proper hand hygieneand sanitation are the most effective ways to prevent the spread of this highly contagious enteric pathogen.

Rationale:

A.Exposure to blood or blood products is the primary transmission route for Hepatitis B and C, but not Hepatitis A. The HAV virus is not typically found in high concentrations in the blood for long periods. Therefore, percutaneous exposure is an extremely rare and unlikely cause of this specific type of viral hepatitis infection.

B.Having unprotected sex is a risk factor for sexually transmitted infections and blood-borne viruses like Hepatitis B and HIV. While some forms of sexual contact involving fecal exposure can transmit Hepatitis A, it is not categorized primarily as a sexually transmitted disease. The most common source in general populations remains contaminated food or water supplies.

C.Sharing needles is a high-risk behavior for transmitting parenteral viruses such as Hepatitis C and B. Hepatitis A is not commonly associated with intravenous drug use unless there is concurrent poor sanitation or fecal contamination. The transmission mechanism of HAV is almost exclusively through the digestive tract rather than through direct bloodstream injection.

D.Eating contaminated food or water is the most likely cause of Hepatitis A. This occurs when food is handled by an infected individual with poor hand hygiene or when water supplies are tainted with sewage. Outbreaks are frequently traced back to raw shellfish or contaminated produce, making enteric precautionsthe standard for preventing the spread of HAV.

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The nurse is planning health teaching about omeprazole for a client who has acute gastritis. What statement will the nurse include in the health teaching?

Nursing Test Bank

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Correct Answer is D

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